Provider Demographics
NPI:1487467973
Name:BLANEY, STEPHANIE JOANN
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JOANN
Last Name:BLANEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:292 NICHOLSON LOOP
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-3846
Mailing Address - Country:US
Mailing Address - Phone:304-288-9493
Mailing Address - Fax:
Practice Address - Street 1:292 NICHOLSON LOOP
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-3846
Practice Address - Country:US
Practice Address - Phone:304-288-9493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant